Being a Pincushion (Important Lab Tests for Diabetes)

Before Type 2 diabetes entered my life, the only times I saw the inside of a testing lab were for pregnancy or for giving blood. After diabetes, I found myself getting blood tests every three months.

On top of those tests, I was now supposed to check my blood sugar levels at home using a glucose monitor and lancets. That meant fingersticks at least once a day. When insulin injections were added to my treatment, I had to learn how to use insulin needles and pens.

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Now I understood why people with diabetes said they felt like pincushions. It was not long before using needles and lancets became routine, but were all the vials of blood I gave at the lab really necessary?

Reading about the complications of diabetes made me realize why doctors insisted on getting all those lab tests with the weird names. Every one of them is important. Here are some common ones and why you need them.

Hemoglobin A1C
In the 1980s this test became available, and today most doctors evaluate A1C every 3–6 months in their patients with diabetes. While glucose checks show what your blood sugar level is at the moment, the A1C test shows your average glucose levels over the past 2–3 months.

It gives a more complete picture of how you are doing, but it may be confusing because the results are read as a percentage instead of the numbers you are used to seeing on your glucose monitor.

Doctors generally like to see an A1C at or below 7% because it means your average blood glucose levels have stayed under roughly 150. That would be high for someone without diabetes, but for those of us with the condition, it means fewer complications from high blood sugar.

You can even buy a kit and check your A1C at home, if you want. For regular use, however, the glucose monitor is still the best way to check for daily highs and lows in blood sugar. In fact, it is the only way to know whether symptoms such as shakiness or sweating are due to your blood sugar being too low, which is something you need to treat fast.

Thyroid tests
You may get a yearly TSH, which is a blood test to see how your thyroid is doing. People with diabetes often have other hormonal problems, and having low or high thyroid makes blood sugar harder to control. It can also lead to weight changes.

If you are on a medicine to correct a thyroid imbalance, as many of us are, you may get this test roughly every three months while the dosage is being adjusted.

If you have symptoms like hair loss, fatigue, sensitivity to cold, problems with sleep, and weight gain or loss for no apparent reason, tell your doctor about them, as these may indicate a thyroid issue.

Lipid tests
Testing for high triglycerides and cholesterol is standard for yearly exams. Having diabetes puts you at increased risk for heart disease, so you might have lipid tests more often than once a year.

Liver function tests
These blood tests help your doctor uncover early problems with your liver. Since many of us are on cholesterol-lowering medications, we need these tests to ensure the drugs aren’t negatively affecting our liver.

So a portion of those vials we give every three months is to check the health of the liver. The AST and ALT tests measure levels of liver enzymes in the blood. Lower- or higher-than-normal numbers are early warning signs of potential liver problems.

Since insulin resistance and fatty liver may be found even before you have developed Type 2 diabetes, out-of-range AST and ALT can give you an early warning about possible health issues.

Kidney function tests
People with diabetes are at increased risk of developing kidney disease. Kidney problems may not be obvious to the person who has them for many years, but blood and urine tests have been developed to warn medical professionals long before serious complications occur.

The microalbumin test looks for albumin, a type of protein, in the urine. If the level is too high, your doctor knows your kidneys are damaged and allowing too much of this protein to leak from the blood into the urine.

The serum creatinine test measures the amount of creatinine in your blood. Creatinine is a by-product of creatine, a compound that is involved in supplying energy so muscles can contract. Too much of creatinine in your blood is a clear sign that your kidneys are not functioning well.

Diabetes specialists keep a watchful eye on your blood and urine tests to make sure the levels of these substances are not out of range. They know this is an important part of keeping your kidneys in good shape.

Being a pincushion is not so bad
Blood and urine tests help us keep an eye out for any diabetes complications that may be developing. Knowing the reasons behind these tests makes me grateful and more than willing to get them. I hope it does the same for you, too.

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